Meals on Wheels - Kai-a-Wira

Meals on Wheels gives you 1/3 of the food you need for the day and then you do the rest

This booklet will show you how

Welcome, Kia Ora, Talofa lava, Kia Orana, Malo e lelei, Fakalofa lahi atu, Ni sa Bula vinaka, Taloha ni, Fakatalofa atu

Whakapai enei kai

E te atua whakapai enei kai Hei oranga mo o matou tinana. Whangai hoki o matou wairua ki te taro o te ora. Ko Ihu

Karaiti to matou Kai-whaka-ora.Amine

Giving Grace

Bless this food as sustenance for our bodies. Nurture our spirits with the nutrients of life.

Amen

What is this booklet about?This booklet is full of great information to help you get the most out of your Meals on Wheels and help you maintain your health and independence.

ContentsMeals on Wheels 1Food Safety 5 Healthy Eating 7 Food Preparation 15 Physical Activity 21

What is Meals on Wheels?Meals on Wheels is for those who need a helping hand with their meals for a while. A hot lunch meal is delivered each weekday, between 11.30 a.m. and 1.30 p.m.Each meal gives you about 1/3 of the food you need for that day. The menu items are all approved by a Dietitian.

How can Meals on Wheels help me?Meals on Wheels will help get you back on track with your food. As we get older we tend to eat less, but a healthy diet is vital for:

• Energy• A strong body and muscles• A sharp mind• Protection from illness• Staying active and independent• Quality of life.

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Is it ok to split my meal and eat some at lunch and some at dinner?No, this is not a good idea. Meals on Wheels gives enough nourishment for ONE meal. If you share it between two meals you won’t be eating enough.

How much does Meals on Wheels cost?The cost of your meals will be discussed with you before the service commences.

How do I pay?There are two ways you can pay:1. Account – an account will be sent to you monthly; or2. Direct Debit Payment – payment will be taken directly from your

bank account to Medirest on the 20th of the month.

Please do not make payment to the volunteer driver who delivers your meals.

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How can I access the Meals on Wheels service?• You need to get a Meals on Wheels referral from a health

professional.• This would be forwarded to the local district health board Needs

Assessment and Service Coordination. • They would then arrange for an assessor to come and assess your

situation.• If you are found to be eligible, they will organise for your Meals on

Wheels to start.

What if I go out during the time the meals are to be dropped off?The volunteers get worried if you aren’t at home to get the meals. If you are going to be out between 11.30 a.m. and 1.30 p.m. please put out an insulated container with a lid for the driver to put your meal in.

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Who can I contact with my Meals on Wheels queries?Telephone Medirest on 276 0044 extension 8715 if:• You are going to be away for more than one day, so you can place

your meals on hold. It is important you remember to do this because you will be charged for all meals delivered to you, whether you are home or not;

• You wish to restart the meals after you have placed them on hold;• You want to cancel your meals altogether;• Your contact details or home address changes;• You have any queries about your accounts;• Your meal hasn’t arrived and it’s later than 1.30 p.m; or• You have any other questions, comments or complaints about Meals

on Wheels.

Please note if you need to make any changes you must contact Medirest one day before the changes or before 8.30 a.m. on the day.

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What is food safety?Food safety refers to the steps we need to follow to make sure food is safe to eat. This is important because unsafe food can give you food poisoning.

How can I keep my Meals on Wheels food safe?Meals on Wheels should be eaten as soon as they are delivered. They are more healthy and enjoyable at that time.If you choose not to eat the meal straight away, put it in the fridge. Don’t leave it on the bench, as this increases your risk of food poisoning.

If someone tries to deliver you a meal after 1.30 p.m. please refuse it.

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How do I reheat my meal after it’s been in the fridge?To keep your meal safe you must reheat it to piping hot. To do this, there are a few options:

• The foil container in which your meal is served is not suitable for use in a microwave oven. If you wish to reheat your meal in the microwave oven you will need to transfer the food to a plate. Cover and microwave for 2-3 minutes or until piping hot right through to the middle.

• Stove/Bench Top Oven: Heat oven to 180oC or 375oF. Pierce the lid or lift a corner. Place your meal in the oven for 15 to 20 minutes or until piping hot right through to the middle.

Remember to stir your food often to make sure it heats through evenly, especially when using your microwave.

Remember, only reheat food once and then throw away any leftovers. Reheating leftovers again can increase your risk of food poisoning.

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What else should I eat?Meals on Wheels is a great start. Each meal gives you about 1/3 of the food you need for the day. But you will also need breakfast, morning tea, afternoon tea, dinner and supper. On the next few pages you’ll find some handy tips for creating a healthy diet.

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Every day eat a variety of foods from the four food groups:1. At least five serves fruit and vegetables - fresh, frozen or canned. 1serve = 1carrot, ½ cup salad, 1kiwifruit, etc.

2. At least six serves wholegrain breads and cereals. 1serve = 1 cup cornflakes, 1 cup cooked pasta/rice, 1 slice of bread, etc.

3. At least two serves milk products. 1 serve = 1 glass milk (250ml), 2 slices cheese, 1 pottle yoghurt, etc.

4. At least one serve meat, chicken, seafood, eggs, beans or lentils. 1 serve = 2 slices cooked meat (100g), ¾ cup casserole/ lentils, 1 egg, 1 kina, etc.

Drink plenty of liquid - water, milk, hot drinks, fruit juice and even soup, custard, jelly or ice blocks. If choosing to drink alcohol, limit your intake and follow advice from your GP/Pharmacist.

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Easy breakfast ideas:• Oats porridge, cooked in milk, with stewed fruit• Weetbix with milk, banana and raisins• Kanga wai (fermented corn) with milk or cream • Scrambled/poached/boiled egg with wholegrain toast• Wholegrain toast with your favourite topping, e.g. jam, peanut butter

or banana

Easy snack ideas:• Muffin, scone or bagel with your favourite topping• Marinated mussels• Smoothie – whiz up 200ml milk, ½ cup yoghurt/ice cream and flavour

with milkshake syrup or ½ cup fruit (soft fresh, frozen or canned)• Cake, fruit loaf or chocolate biscuits• Powdered protein/milk based drinks from the supermarket or chemist• Wholegrain bread/rolls or crackers with your favourite topping e.g.

cheese, tomato, baked beans, or hummus

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Easy meal ideas:• Two minute noodles mixed with frozen mixed vegetables and tuna• Baked potato with baked beans and sour cream with a salad• Boil Up with lean meat, watercress or puha and dough boys• Bowl of soup with wholemeal bread/roll • Chicken in hamburger bun with lettuce, tomato, and avocado• Crumbed fish or chicken nuggets and oven fries baked in the oven

with a fresh salad• Frozen meals from the supermarket or other home delivery services• Mini pizza – spread pita bread with tomato paste and add your

favourite toppings e.g. tomato, mushroom, salami, cheese• Pasta with pasta sauce and mixed veg with grated cheese on top• Paua, pipi or mussel fritters with a salad• An egg on English muffin with grated cheese, tomato and parsley• Toasted sandwiches with your favourite filling e.g. creamed corn

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Easy dessert ideas:• Jelly, ice cream, yogurt or

custard with fresh, canned or stewed fruit

• Fruit crumble• Hot drink and two biscuits • Kanga wai (fermented corn)

with milk or cream• Pikelets with jam and

whipped cream• Ready to eat individual

desserts from the supermarket e.g. cheesecake, steamed pudding, or small cans of rice pudding

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How can I prevent constipation?• Eat plenty of wholegrain

breads, breakfast cereals, vegetables and fruit.

• Prunes, kiwifruit and orange juice are particularly helpful.

• Increase your fluid intake.• Do some regular activity every

day, such as walking.

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What do I do if I start to have eating and drinking difficulties?Difficulties chewing and swallowing food and drink are common. This can vary from problems with chewing dry or hard foods to coughing and choking on food and drink.

The following information is a guide only – contact your GP if you have any concerns or queries or if you:• Often cough when eating and drinking• Have trouble chewing hard foods• Have spells of choking• Notice that food gets stuck in and around your mouth• Are losing weight• Notice that you drool saliva

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Some tips:• Ensure your dentures are well fitted• Reduce distractions during mealtimes• Ensure you sit up while eating• Take your time over meals• Ensure you cut food into bite sized pieces• Add extra sauce or gravy if the food seems too dry• Take small sips of drink • Clean your teeth and mouth after a meal• Stay sitting up for 30 minutes after a meal

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How can I make food preparation easier?Sometimes making food can be difficult. Especially if you:• are tired; • have low vision; • lack motivation; or• have memory issues.

On the next few pages are some handy tips to help you overcome these issues.

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How can I conserve energy?• Take a break before you start an activity.• Plan and organise so that you’re not rushed.• Reduce clutter on your bench and floor. Clutter means you have to

concentrate more to move around and that can increase your risk of falling.

• Store items in small containers, as they are easier to lift than large ones.

• Avoid reaching and bending too much. • Slide objects along the bench instead of lifting them.• Sit to prepare meals instead of standing.• Ask someone else to help you with difficult and tiring tasks.

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What can I do to help with my low vision?• Make sure there is enough light.• Remember to put on your glasses.• Avoid long sleeves and loose clothing while cooking as they can

dangle into hot pans.• Get to know the controls on your oven and other kitchen

appliances. You can place raised stickers on them to help you.• Consider colour contrast e.g. use a light

coloured mug when preparing hot drinks, chop light colour foods on dark coloured chopping boards

• Turn saucepan handles away from the front of the cooker so you don’t knock them.

• Practice making simple meals while your family, whānau or friends are around.

• If your vision worries you, contact the Royal New Zealand Foundation of the Blind on 0800 243 333. They can organise an assessment and give you information about equipment that can help you.

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How can I increase my motivation to eat?• Increase your activity levels to help increase your appetite.• Incorporate eating into your daily routine.• Turn your meals into a social event by inviting family, whānau

or friends to join you or by eating during your favourite TV programme.

• Enjoy your meals with foods that have appealing aromas or flavours.

• Enjoy some meals outside - just 30 minutes outside will get your daily dose of vitamin D from the sun. The sun’s rays are safest before 11.00 a.m and after 4.00 p.m

• Try out a new recipe from time to time.

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What can I do to help with my memory issues?• Plan and organise your meals – write your

plan down.• Aim for six small meals a day - breakfast,

lunch and dinner with in-between meal snacks and something to eat for supper.

• Label drawers and cupboards and pop one on the kitchen door to remind you to turn off the electrics/gas.

• Have your meals at the same time each day.• Stick to simple and routine cooking.• Inform family, whānau or friends when you

intend to eat. Then they can remind you when to start preparing each meal.

If you are struggling with tiredness, vision, motivation, memory or physical difficulties, ask your doctor for a referral to an occupational therapist.

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Keep Moving!!!Exercise can make you feel better. It may help you be able to do more and live longer! It can also help to prevent falls. There are lots of ways to become more active. On the next few pages you’ll find some handy tips to get yourself moving.

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Is it safe for me to exercise?It is safe for most adults over 65 years to exercise. Even if you have things like heart disease, high blood pressure, diabetes and arthritis. Many of these conditions can get better with exercise. If you are not sure if exercise is safe for you check with your doctor next time you’re there.

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How do I get started?• Wear loose,

comfortable clothing and sturdy shoes.

• If you aren’t already active, begin slowly.

• Start with exercises that you already find easy.

• Great activities to start with are walking and the exercises on the next page.

• As you get used to exercising you can slowly increase the intensity of your exercise program.

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What exercises should I do?• Try and do some physical activity for at least 30 minutes on

most days. • Warm up for five minutes before each exercise session.

Walking slowly and stretching are good warm up activities. • Sit on a chair, stand up then sit down again and repeat.• Sit on a chair, raise one leg up and down then the other leg

and repeat• Stand or sit with a can of food in each hand, hang your arms

by your side then bend your elbow and raise the can of food up to your shoulder, lower your arm and repeat.

• Go for a walk.• Finish your exercise with a five minute “cool down” by doing

more stretches.

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How can my community help?• Try calling your local council for some ideas

- there are lots of exercise programmes and public swimming pools around.

• Talk to your GP about getting a “Green Prescription” for a local exercise programme.

• ACC offers Tai Chi classes and the Otago Falls Prevention Exercise Program.

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When should I call my doctor?If your muscles or joints are sore the day after exercising, you may have done too much. Next time, exercise at a lower intensity.

If pain or discomfort persists, please talk to your doctor.

You should also talk to your doctor if you have any of the following symptoms while exercising:• Chest pain or pressure• Trouble breathing or excessive shortness of breath• Light headedness or dizziness• Difficulty with balance• Nausea

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August 2009 © Julia Bates The background material for this resource booklet was produced as part of

Julia’s requirements for her University of Otago Post Graduate Diploma in Dietetics.With thanks to Raukura Hauora o Tainui ki Tamaki.